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Restless Leg Syndrome – Testing

October 30, 2020


Often patients come to me complaining that they can’t fall asleep at night and they think it’s insomnia, which it is in a way cause they can’t fall asleep. But the real reason may be that their legs bother them. So on a simple sleep symptom questionnaire, I asked variety of questions. Most that their own doctors have never asked. And one of those is about their legs. And when they tell me that they have some uncomfortable sensation that tends to occur in the evenings and is associated with the urge to move, that’s relieved by rest, I can make the diagnosis of restless leg syndrome. So it prevents people from falling asleep and it gets in the way of the quality of their sleep. But the diagnosis is fairly simple. It’s a clinical diagnosis. They tell me their symptoms and I give them the diagnosis. But what we always want to do is figure out if there’s some reversible costs for it.

So invariably, I’m gonna order some labs. I’ll look at their kidney function. I’ll look at their risk for anemia to make sure their red cell count is not low. I always measure ferritin, which is a measurement of iron and some blood chemistries and some minerals that help relax muscles like magnesium and calcium. We also look at thyroid function. So we’re simply looking at a simple group of labs that give us a lot of information. I love to see a low iron value because it’s so easy to fix cheap over the counter. Iron will actually treat a big group of people about 20% of restless legs or RLS is just low iron. Interestingly, about 75% of people with RLS actually have high iron. So it can be a confusing diagnosis to make for an untrained professional who doesn’t see this every day, but labs are always important in making the diagnosis. But at the end of the day, it’s a clinical diagnosis.

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